An intensive, 18-month diet and exercise program was found to reduce knee pain, improve quality of life and function, and increase walking distance among patients with knee osteoarthritis (OA), overweight, and obesity, according to study results presented at the American College of Rheumatology (ACR) Convergence 2022, held from November 10 to 14, in Philadelphia, Pennsylvania.
Researchers conducted a pragmatic, assessor-blinded, randomized, controlled trial (WE CAN) to analyze the impact of intensive diet and exercise on knee pain, based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee pain scores. Participants were randomly assigned to an 18-month diet and exercise program or an attention control group.
The primary endpoint was between-group differences in WOMAC knee pain at 18 months. Secondary endpoints included the Short Form-36 (SF-36) health-related quality of life, the 6-minute walk test (6MWT), and the WOMAC function score.
Among a total of 823 patients (77% women; mean age, 64.6 years) with knee OA, overweight, and obesity, 658 (80%) completed the study.
At 18 months, patients who underwent an intensive diet and exercise regimen had a mean loss in body weight of 10.9 kg (24.0 lb) compared with control participants who had a mean loss in body weight of 2.7 kg (5.9 lb; mean difference, 8.6 kg [18.9 lb]; 95% CI, 5.4-11.9 kg [11.9-26.2 lb]; P <.0001).
Mean WOMAC knee pain scores at 18 months also significantly decreased in the treatment vs control group (4.9 vs 5.5 points, respectively; adjusted difference, -0.6 points; 95% CI, -1.0 to -0.1 points; P =.025).
Compared with the control participants, patients who were a part of the diet and exercise intervention had the following functions:
- walked further on the 6MWT (419 vs. 376 m; adjusted difference, 43 m; 95% CI, 31-55m; P <.0001),
- scored higher on the SF-36 physical health-related quality of life (41.3 vs 37.5; adjusted difference, 3.8; 95% CI, 2.5-5.2; P <.0001), and
- improved WOMAC function scores (16.4 vs. 19.7 points; adjusted difference: -3.3 points; 95% CI, -4.9 to -1.7 points; P <.0001).
“This study provides a blueprint for the implementation of a successful treatment for a pervasive public health problem in clinical and community settings,” the study authors concluded.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
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Messier S, Beavers D, Queen K, et al. Effectiveness of intensive diet and exercise on knee pain among communities with knee osteoarthritis, overweight, and obesity: the WE CAN pragmatic randomized clinical trial. Presented at: ACR Convergence 2022; November 10-14; Philadelphia, PA. Abstract #1675.